817 Mr Henry RdDav
ME -4
Qhs 1�, All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Davie County, Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
�OUN4r NC or arising out of the use or inability to use the GIS data provided by this website.
WARNING: THIS IS NOT A SURVEY
Parcel Inforrriation
Parcel Number:
L30000000702
Township:
Mocksville
NCPIN Number:
5716867813
Municipality:
Account Number:
43597000
Census Tract:
37059-801
Listed Owner 1:
KURFEES CHARLES M
Voting Precinct:
SOUTH CALAHALN
Mailing Address 1:
817 MR HENRY ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
20.00 AC MR HENRY RD
Fire Response District:
SCOTCH - IRISH
Assessed Acreage:
20.00
Elementary School Zone:
COOLEEMEE
Deed Date:
6/1992
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
001640160
Soil Types: GnB2,EnB,EnC,ChA,BuB,WATER,MsD
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
225910.00
Outbuilding & Extra
Freatures Value:
4110.00
Land Value:
120400.00
Total Market Value:
350420.00
Total Assessed Value:
259710.00
Qhs 1�, All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Davie County, Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
�OUN4r NC or arising out of the use or inability to use the GIS data provided by this website.
�� "y ►-�- "= t_ DAVIE COUNTY HEALTH DEPARTMENT
_ g IMPROVEMENTS PERMIT AND; CERTIFICATE OF COMPLETION
' NOTfL: Issued in Compliance With Article 11 of G.S. Chapter 130a
Sanitary Sewage Systems /C%� r �• !� �' _ Perm -it Ca oNumber
Name �N� I7i�� /%rr '� c,''%f, R _� �� Date Z2—Z2 1Z5 6
Location /ri/�/r
Subdivision Name
Lot No. Sec. or Block No.
Lot Size OIX 215'C House -�'�
Mobile Home — Business --
Industry
No. Bedrooms %-�--.No.
Baths !`� J''
No. in Family — Public Assembly
Other
Garbage Disposal
YES ❑ NO []'
Specifications for System:
Auto Dish Washer
YES NO ❑
�-
S ��r r- �'
%�t(f
Auto Wash Ma^hine
YES NO ❑
!
f'
/moi% fJcl
Type Water Supply
`).twif
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
Improvements permit by _� 1
*Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephonq
Number: 704-634-5985.
Final Installation Diagram: Sy t Insta d by — `'�- 1 �dh4* !.�4
\IS 0
na
Certificate of Completion' Date 7/ice
'The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMI �
Davie County Health Department
Environmental Health Section DEC 1 1994P. O. Box 665
Mocksville, NC 27028
1. Application/Permit Requested By t t' U n I C c
Mailing Address I�0 5 R I U V 1 L c) Tn Lk: , n h r1(-1 .73 e S Home Phone ( Ci IcH
k a 8 N 0 'a �7 ()0 (n Business Phone C l o�
2. Name on Permit if Different than Above
3. Application for: ❑ General Evaluation UKeptic Tank Installation Permit
4. System to Serve: &I -louse
❑ Business ❑ Industry
5. If house, mobile home: Subdivision
No. of People
No. of Bedrooms
❑ Mobile Home ❑ Place of Public Assembly
❑ Other ❑ Unknown
No. of Bathrooms d1 /')-
Dwelling Dimensions W4 DQ .n{_ _ I+
6. If business, industry, place of public assembly, other: Specify type
No. of People Served No. of Sinks
No. of Commodes No. of Urinals
No. of Lavatories No. of Water Coolers.
No. of Showers Water Usage Figures.
7. Type of water supply: ❑ Public P Private
8. Property Dimensions (-) 0-t^ ,SA Sewage Disposal Contractoi
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve?
If yes, what type?
Section Lot #
❑ Basement/Plumbing
❑ Basement/No Plumbing
VWashing Machine
P/Dishwasher
❑ Garbage Disposal
❑ Yes D-I�o
❑ Community
'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property: h,C,
pp P !n
C Cmc �� svuJ h+ cross +D {71f �rnry 4D
This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges
incurred from this application.
l - Q I-9 ' 4�5zz 1 - �1, ///� -
DATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
mo. i
MUST CHECK ONE: IOWN the property. ❑ 2. 1 DO NOT OWN the property.
If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
I hereby give consent to the authorized representative of the Pavie County Health Dep rtment to enter upon above described
property located in Davie County and owned by ` F' k ic A sZA
to conduct all testing procedures as necessary to determine said site's suitabilit ora groubd absorption sewage treatment
and disposal system.
DATE
DCHD (7193)
r
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME YC5 DATE EVALUATED
ADDRESS ^ / PROPERTY SIZE c20-"-4
PROPOSED FACIILTY�'CIGtS'-P LOCATION OF SITE
Water Supply: On -Site Well
Community
Public
Evaluation By: Auger Boring V*111 Pit Cut
FACTORS 1
2
3
4
Landscape position ,G
L -
Slope 9.
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
�G
-
Texture group
C
Consistence
Structure//
/ l
Mineralogy
HORIZON III DEPTH
Texture group'
Consistence
Structure '
Mineralogy:
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
`
SITE CLASSIFICATION: -tle --70 '10�
LONG-TERM ACCEPTANCE RA
REMARKS: (�IIP�•�J��
DCHD(01-901
EVALUATED BY: 4 &
OTHER(S) PRESENT:
LEG
Landscape Position
R -Ridge S -Shoulder L -Linear slope FS-Footslope N -Nose slope
CC -Concave slope CV -Convex slope T -Terrace FP -Flood plain H -Head slope
Texture
S -Sand LS -Loamy sand SL -Sandy loam L -Loam SI -Silt
SICL-Silty :lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam
SC -Sandy clay SIC -Silty clay C -Clay
CONSISTENCE
Moist
VFR-Very friable FR -Friable FI -Firm VFI-Very firm EFI-Extremely firm
Wet
NS -Non sticky SS -Slightly sticky S -Sticky VS -Very Sticky
NP -Non plastic SP -Slightly plastic P -Plastic VP -Very plastic
Structure
SC -Single grain M -Massive CR -Crumb GR -Granular ABK-Angular blocky
SBK-Subangular blocky PL -Platy PR -Prismatic
Mineraloity
1:1, 2:1, Mixed
Notes
Horizon depth - In inches
Depth of fill - In inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil wetness - Inches from land surface to free water' or inches from land surface to soil colors
with chroma 2 or less
Classification - S(suitable), PS(provisionally suitable), U(unsuitable)
LTAR - Long-term acceptance rate - gal/day/ft2